Supplement articleAnaphylaxis in the Young Adult Population
Section snippets
Epidemiology and Impact
Anaphylaxis is defined as “a severe, potentially fatal, systemic allergic reaction that occurs suddenly after contact with an allergy-causing substance.”11 Several studies have shown increases in the incidence of anaphylaxis in the population at large.3, 12, 13, 14, 15, 16 Common triggers include foods, drugs, chemicals, insect venom, and exercise. The top 8 food allergens associated with anaphylaxis are peanuts, cow's milk, shellfish, tree nuts, eggs, fin fish, wheat, and soy.17 Common
Signs and Symptoms
Signs and symptoms of anaphylaxis primarily involve the mucocutaneous, respiratory, cardiovascular, and gastrointestinal systems (Figure 2).9, 29, 30, 31 The National Institute of Allergy and Infectious Diseases (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) have developed diagnostic criteria for food-induced anaphylaxis,11 as discussed in more detail in the earlier article in this supplement by Dr Phillip Lieberman.32 (Note: As of November 12, 2012, FAAN merged with the Food
Management
The management strategy discussed earlier in this supplement32 and general treatment guidelines are often not easily translated into clinical practice in young adults. A recent chart review conducted at 3 clinics in the Chicago area revealed a stark difference between developing and disseminating guidelines and actually implementing guidelines into clinical practice. For example, only 55% of charts documented prescription of an epinephrine autoinjector, 33% of charts documented patient
Conclusions
The rate of anaphylaxis is increasing in adolescents and young adults. Proper diagnosis and management are critical, as is counseling and education for this special population. All adolescents should be educated about signs and symptoms of anaphylaxis and how and when to use an epinephrine autoinjector. Increased risk-taking behaviors, dating, and transitioning care from adults to patients, among other factors, must be addressed. Management strategies also must be followed in public places
Acknowledgments
This article is based on a presentation authored and delivered by Ruchi S. Gupta, MD, MPH, at the multidisciplinary Partnership for Anaphylaxis Round Table meeting, held in November 2012, in Dallas, Texas. The round table meeting was supported by Mylan Specialty L.P. Medical writing and editorial assistance for the preparation of this manuscript were provided by Jeff Kuper, PharmD, of PharmaWrite, LLC, and were funded by Mylan Specialty L.P. This manuscript is an original work and was prepared
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Funding: This work was supported by Mylan Specialty L.P.
Conflict of Interest: Ruchi S. Gupta, MD, MPH has served as an advisor and speaker for Mylan Specialty L.P.; she received an honorarium from Mylan for attending the Partnership for Anaphylaxis Round Table. No payment was received for writing of this manuscript. Dr Gupta has received research support from the National Institutes of Health, Mylan, and FARE.
Authorship: Dr Gupta fully qualifies for authorship of the manuscript, having made substantial contributions to the conception and design of the work; the acquisition, analysis, and interpretation of data for the work; and the identification and interpretation of the appropriate published literature. She was involved in drafting and critically revising the manuscript for important intellectual content, reviewed the final manuscript, and gave approval for submission. Dr Gupta is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.